US9295447B2 - Systems and methods for identifying vascular borders - Google Patents
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- US9295447B2 US9295447B2 US13/212,004 US201113212004A US9295447B2 US 9295447 B2 US9295447 B2 US 9295447B2 US 201113212004 A US201113212004 A US 201113212004A US 9295447 B2 US9295447 B2 US 9295447B2
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
- A61B8/0883—Detecting organic movements or changes, e.g. tumours, cysts, swellings for diagnosis of the heart
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0033—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room
- A61B5/0035—Features or image-related aspects of imaging apparatus classified in A61B5/00, e.g. for MRI, optical tomography or impedance tomography apparatus; arrangements of imaging apparatus in a room adapted for acquisition of images from more than one imaging mode, e.g. combining MRI and optical tomography
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0093—Detecting, measuring or recording by applying one single type of energy and measuring its conversion into another type of energy
- A61B5/0095—Detecting, measuring or recording by applying one single type of energy and measuring its conversion into another type of energy by applying light and detecting acoustic waves, i.e. photoacoustic measurements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
- A61B8/0891—Detecting organic movements or changes, e.g. tumours, cysts, swellings for diagnosis of blood vessels
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/52—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/5215—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01B—MEASURING LENGTH, THICKNESS OR SIMILAR LINEAR DIMENSIONS; MEASURING ANGLES; MEASURING AREAS; MEASURING IRREGULARITIES OF SURFACES OR CONTOURS
- G01B11/00—Measuring arrangements characterised by the use of optical techniques
- G01B11/24—Measuring arrangements characterised by the use of optical techniques for measuring contours or curvatures
- G01B11/25—Measuring arrangements characterised by the use of optical techniques for measuring contours or curvatures by projecting a pattern, e.g. one or more lines, moiré fringes on the object
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- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G06T7/00—Image analysis
-
- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G06T7/00—Image analysis
- G06T7/0002—Inspection of images, e.g. flaw detection
- G06T7/0012—Biomedical image inspection
-
- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G06T7/00—Image analysis
- G06T7/10—Segmentation; Edge detection
-
- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
- G06T9/00—Image coding
- G06T9/20—Contour coding, e.g. using detection of edges
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
- G16H50/20—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/02007—Evaluating blood vessel condition, e.g. elasticity, compliance
Definitions
- Embodiments of the present disclosure relate generally to the field of medical devices and, more particularly, to the use of intravascular imaging systems to identify a vascular border.
- heart disease is a leading cause of death and disability.
- One particular kind of heart disease is atherosclerosis, which involves the degeneration of the walls and lumen of the arteries throughout the body. Scientific studies have demonstrated the thickening of an arterial wall and eventual encroachment of the tissue into the lumen as fatty material builds upon the vessel walls. The fatty material is known as “plaque.” As the plaque builds up and the lumen narrows, blood flow is restricted. If the artery narrows too much, or if a blood clot forms at an injured plaque site (lesion), flow is severely reduced, or cut off and consequently the muscle that it supports may be injured or die due to a lack of oxygen.
- Atherosclerosis can occur throughout the human body, but it is most life threatening when it involves the coronary arteries which supply oxygen to the heart. If blood flow to the heart is significantly reduced or cut off, a myocardial infarction or “heart attack” often occurs. If not treated in sufficient time, a heart attack often leads to death. Further, the weakening of vessel walls can lead to an aneurysm or swelling of the vessel that, if left untreated, will rupture and lead to internal bleeding and often death. Aneurysms commonly occur in the aorta.
- PTCA percutaneous transluminal coronary angioplasty
- an endovascular aortic repair (EVAR) or thoracic endovascular aortic repair (TEVAR) may be utilized to introduce a stent graft into the vasculature.
- EVAR endovascular aortic repair
- TEVAR thoracic endovascular aortic repair
- Such techniques have traditionally relied on CT scans performed before surgery and angiograms during surgery to identify important anatomical features of the vasculature associated with the interventions.
- the information from a CT scan is often inaccurate at the time of surgery since the aneurysm or other condition is continually evolving over time.
- IVUS Intravascular Ultrasound
- the technique employs one or more very small transducers arranged towards the end of a catheter to provide electronically transduced echo signals to an external imaging system in order to produce a two or three-dimensional image of the lumen, the vessel tissue, and/or the tissue surrounding the vessel.
- IVUS images allow a user to view the form and structure of a site within a vessel rather then merely determining that blood is flowing through a vessel.
- IVPA Intravascular Photoacoustic
- the imaging catheters, systems, and associated methods of the present disclosure overcome one or more of the shortcomings of the prior art.
- a method comprises gathering intravascular photoacoustic (IVPA) data using a transducer inserted into a vessel of a patient. The method further includes modulating the IVPA data to determine a first tissue border and displaying a border map representing the first tissue border.
- IVPA intravascular photoacoustic
- a system comprises a catheter including an elongated flexible body having a lumen extending along its length from a proximal portion to a distal portion and a transducer positioned adjacent the distal portion.
- the transducer is configured to gather intravascular photoacoustic (IVPA) data.
- the system further includes a program executable by a computer and configured to modulate the IVPA data to determine a first tissue border of a vessel and to prepare a border map representing the first tissue border.
- a method comprises providing an imaging probe for use in a vessel.
- the imaging probe includes at least one transducer configured to gather intravascular photoacoustic (IVPA) data and intravascular ultrasound (IVUS) data.
- the method further comprises generating an IVPA image using the IVPA data and generating an IVUS image using the IVUS data.
- the method further includes coregistering the IVPA and IVUS images to display a combined image.
- the method includes modulating the IVPA data to identify a first border of a tissue type of the vessel and displaying a border map representing the first border on the combined image.
- FIG. 1 is a vascular border identification system in accordance with one embodiment of the present disclosure.
- FIG. 2 illustrates a method for identifying a vascular border in accordance with one or more embodiments of the present disclosure.
- FIG. 3 illustrates an intravascular photoacoustic (IVPA) image.
- IVPA intravascular photoacoustic
- FIG. 4 illustrates a vascular border map image
- FIG. 5 illustrates a combined image of the IVPA and vascular border map images.
- FIG. 6 illustrates an intravascular ultrasound (IVUS) image.
- IVUS intravascular ultrasound
- FIG. 7 illustrates the combined image of the IVUS and vascular border map images.
- a vascular border identification system 100 includes a control console 102 connected via a catheter 104 to an imaging probe 106 .
- the distal end of the imaging probe 106 includes a transducer 108 .
- the imaging probe is inserted into a blood vessel of a patient and gathers data about the vascular tissue through signals received by the transducer 108 .
- the data is received by the control console 102 and provided to a computer 110 for storage and processing.
- An image representing the data is displayed on a display device 112 .
- the display device 112 may be integrated into the control console 102 or may be a separate piece of equipment.
- the control console 102 may include one or more components for controlling the function of the imaging probe 106 and receiving data from the probe.
- the control console 102 is an integrated console including both intravascular photoacoustic (IVPA) component and an intravascular ultrasound (IVUS) components.
- the control console may include an optical coherence tomography (OCT) component, an MRI component, a thermographic component, or any other modality of an imaging component known in the art.
- OCT optical coherence tomography
- the computer 110 includes a processor 114 and a memory device 116 .
- the computer 110 is operable to execute a software program 118 for analyzing data from the imaging probe 106 and for preparing information for display on the display device 112 .
- the computer 110 may be a personal computer, programmable logic device, or any other data processing device that is known in the art.
- the computer 110 may further include other software or hardware, such as input/output devices and networking devices, known in the art.
- the imaging probe 106 is an integrated imaging probe which allows for both IVUS and IVPA imaging.
- the transducer 108 provides both a signal transmission and a signal reception function.
- the transducer transmits ultrasonic waves, such as radio frequency (RF) waves, and receives echo waves backscattered from the vascular tissue.
- the transducer 108 may include a piezoelectric transducer, a piezoelectric micro-machined ultrasonic transducer (PMUT), a polyvinylidene fluoride (PVDF) transducer, or any other transducer device known in the art.
- IVUS data may be gathered in segments, either through a rotating transducer or an array of circumferentially positioned transducers, where each segment represents an angular portion of the resultant image. Thus, it takes a plurality of segments to image an entire cross-section of a vascular object. Furthermore, multiple sets of IVUS data may be gathered from multiple locations within a vascular object, for example, by moving the transducer linearly through the vessel. These multiple sets of data can then be used to create a plurality of two-dimensional (2D) or three-dimensional (3D) images. In some embodiments, one or more motors may be used to rotate or linearly move the transducer to obtain the data segments.
- 2D two-dimensional
- 3D three-dimensional
- the IVUS imaging equipment includes components similar or identical to those found in IVUS products from Volcano Corporation, such as the Eagle Eye® Gold Catheter, the Visions® PV8.2F Catheter, the Visions® PV 018 Catheter, and/or the Revolution® 45 MHz Catheter, and/or IVUS products available from other manufacturers.
- the catheter system 100 includes components or features similar or identical to those disclosed in U.S. Pat. Nos.
- the imaging probe 106 includes a light transmitting device capable of transmitting photons and a signal receiving device capable of receiving acoustic signals.
- the transducer 108 may function to receive both the returned IVUS and IVPA acoustic signals or a separate IVPA transducer may be used.
- the light transmitting device includes a light source, such as a laser, and a light transmission guide such as one or more optical fibers.
- the catheter system 100 includes components or features similar or identical to those described in U.S. patent application Ser. No.
- certain components of the integrated IVUS/IVPA probe may be separated.
- the light transmitting source may be supplied by a separate probe. With a separated light transmitting source, the light may be transmitted from within the vessel, from outside the vessel, or from outside the body.
- the catheter 104 includes a lumen which allows the catheter to pass over a guide wire (not shown).
- the imaging probe 106 further includes a lumen which allows it to pass over the guide wire.
- the vascular border identification system 100 may be utilized as shown in the method 120 of FIG. 2 to determine the borders of various vascular tissue.
- Use of the system according the described method may provide important clinical information to a user physician. For example, a determination of the tissue borders can be used to determine the extent of stenosis and coronary disease progression. Such a determination can be used to further determine whether additional procedures such as angioplasty or atherectomy are indicated or whether more invasive procedures are warranted.
- a method 120 includes the step 122 of inserting the imaging probe 106 into a blood vessel.
- the imaging probe 106 and catheter 104 may be routed along a guide wire extending into the blood vessel.
- the blood vessel may be an artery but the term encompasses any structure of the cardiovascular system of a human or animal.
- an imaging probe may be directed through other body passages including lymphatic vessels, the esophagus, stomach, intestines, ureter, urethra, trachea, sinuses, Eustachian tubes, bile ducts, or pancreatic ducts.
- IVPA and IVUS signals are transmitted by the imaging probe.
- the light transmitting source for the IVPA system may be located outside the blood vessel.
- IVPA and IVUS data is collected via the imaging probe 106 and received by the computer 110 through the control console 102 .
- an IVUS image 212 FIG. 6
- an IVPA image 200 FIG. 3
- the IVUS and IVPA images may be displayed on the same display device by toggling between the two images. Alternatively, the images may be displayed on different display devices. In still another alternative, the images may be co-registered and displayed together, at the same time, one a single display device.
- the computer 110 executes a border mapping application to identify the location of borders between various tissue types such as intima, medial, and adventitial vascular tissue; blood tissue; and plaque tissue (including calcified tissues, fibrous tissues, calcified-necrotic tissues and fibro-lipidic tissues).
- the border mapping application may identify the location of the luminal border which demarcates the blood-intima interface or the location of the medial-adventitial border which demarcates the boundary between the media and advnetitia tissues.
- the border mapping application modulates the IVPA data using multiple data processing operations applied serially, in parallel, or a combination thereof.
- the data modulation utilizes one or more features of the IVPA image 200 of the blood vessel to generate a border map 210 depicting a catheter border 210 a , a luminal border 210 b , and a medial-adventitial border 210 c ( FIG. 4 ).
- the border map 210 may include a plurality of border control points 210 d .
- the border map, including the border points may be displayed using a graphic image uniquely distinguishable from an IVPA or IVUS image.
- solid or dashed lines, graphic markers, and colored map regions may be used to graphically represent the border map on an IVPA or IVUS image.
- graphics including for markers or map regions, may correspond to a key indicating the predetermined meanings of the colors or the markers.
- data modulation may include reference to predetermined and stored information about the characteristics of the tissue types. Additionally or alternatively, the data modulation utilizes a plurality of initial filtering operations having different filter coefficients and filter pass band characteristics. The output of the initial filtering operations is used to generate a secondary IVPA image. The secondary image is further filtered to generate a binary map showing the potential locations of border points along the vascular border. The border points may be used to generate the border map.
- the IVPA image may be filtered based upon characteristics such as signal intensity, slope, or changes in gradient/intensity.
- the filtering operations may be performed in parallel or in multiple stages.
- Data modulation may be performed by hardware or software. For example, in one embodiment, field programmable gate arrays (FGPA's) or custom application-specific integrated circuits (ASIC's) could be used to perform the data modulation in hardware.
- FGPA's field programmable gate arrays
- ASIC's application-specific integrated circuits
- the data modulation may be performed using analog components or using micro-controllers or a graphics card.
- the data modulation may be performed in software. The data modulation may be in real time or generated after a delay.
- the border map image 210 is displayed either alone ( FIG. 4 ) or in co-registration with the IVPA image 200 ( FIG. 5 ).
- the combined image of the IVPA image 200 and the border map image 210 is displayed on a display device for viewing by a user.
- user input may be used to modify the border map 210 by adjusting one or more border control points 210 d of the border map. It should be noted that the number, location, and size of the control points of the border map image 210 are illustrative only and should not be limiting.
- the border control points may be manually repositioned in that the user may select and move one of the control points with an input device (e.g. a mouse, a touch screen, key strokes). Further details may be found in U.S. Pat. Pub. No. 2008/0287795, which is incorporated by reference in its entirety herein.
- an input device e.g. a mouse, a touch screen, key strokes.
- the modified border map image is displayed.
- the border image 210 and the IVUS image 212 are coregistered and displayed ( FIG. 7 ).
- the IVPA image 200 may also be coregistered with the border image 210 and the IVUS image 212 for displaying a combined image on the display device.
- the IVPA and IVUS images can be coregistered by superimposing one image on the other.
- coregistration may be performed using a marker or indicia.
- the IVPA probe acquires one or more markers and the IVUS probe acquires the same one or more markers. Based upon the alignment of the one or more markers, the separately acquired images can be coregistered.
- IVUS images display the mechanical properties of the tissue. For example, with IVUS, it is possible to observe structures deep within the tissue where acoustic mismatches generate reflections.
- IVPA displays the optical properties of the tissue. For example, different plaque types will have different optical properties, and thus generate different responses. Both IVUS and IVPA generate images from the same region using different properties, both of which can be important in clinical assessments.
- border mapping process has been described using IVPA and IVUS imaging modalities, it is understood that the same general steps could be applied using other modalities such as OCT or MRI.
Abstract
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US13/212,004 US9295447B2 (en) | 2011-08-17 | 2011-08-17 | Systems and methods for identifying vascular borders |
PCT/US2012/050565 WO2013025602A1 (en) | 2011-08-17 | 2012-08-13 | Systems and methods for identifying vascular borders |
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US13/212,004 US9295447B2 (en) | 2011-08-17 | 2011-08-17 | Systems and methods for identifying vascular borders |
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